Patterns of hand drift in parietal lobe lesion

Abstract

Clinical signs that help in detecting subtle weakness are invaluable in reaching early localisation of lesion and diagnosis. The parietal drift is a useful clinical sign that is helpful in localizing to parietal lobe. 1) To characterize the parietal drifts which are observed on the basis of extent, direction, and hand and finger movements. 2) To study association between direction of the drift and underlying causative lesion in brain parenchyma. Study conducted at tertiary care centre over a duration of 12 months, where hand drift, fingers movement and any abnormal posturing of fingers and wrist were noted by the two expert assessors separately, for a period of 20-30 seconds each. The drift is described in each patient on the basis of following six parameters. 1) Curling of fingers 2) Outstretching of thumb 3) Outward drift of hand 4) Upward drift of hand 5) Downward drift of hand 6) Pronation of hand 1) Patients having lesions in parietal lobe demonstrated hand drift which consisted of hand movement in outward, upward or rarely in downward direction. 2) Patients having lesion in the Parieto-occipital regions demonstrated hand drift which consisted of hand movement in outward and upward direction 3) Patients having lesion in Parieto Temporal regions, demonstrated hand drift which consisted of hand movement in upward but NOT outward direction. 4) An attempt can be made to localize site of lesion whilst awaiting radiological images by simple characterisation of this clinical sign